Archived: Dimensions 101 Pinewood Avenue

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

Dimensions 101 Pinewood Avenue is a care home without nursing, located in Crowthorne. It provides accommodation and personal care support to up to four people living with a learning disability. Some people may have additional physical disabilities. Three people were living in the service at the time of this inspection. A registered manager was in post.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service had addressed the areas of concern we identified in April 2016. The sluice had been removed from the bathroom and replaced with a new washing machine incorporating a sluice programme. Its removal had enabled more effective cleaning of hard to reach areas and the staining in the bath had also been reduced. The bathroom had been redecorated.

One person had been reassessed as requiring nursing care and had moved to a nursing home which would better meet their needs.

An ensuite wet room shower had been provided to ensure another person’s safety and dignity while showering.

Dimensions 101 Pinewood Avenue is a care home which is registered to provide care (without nursing) for up to four people with learning and physical disabilities. The home is a detached building in Crowthorne close to local shops and other amenities. People had their own bedrooms and use of communal areas that included an enclosed private garden. The people living in the home needed care and support from staff at all times and have a range of care needs.

The home has a registered manager who works full-time within the home and two other small registered services. The registered manager is supported by a deputy manager who also spends equal time between the three registered services. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were effective systems to regularly assess and monitor the quality of service that people received. Various formal methods included unannounced visits by one of the organisations regional managers and health and safety audits that were completed by the registered manager. However, following review and assessment of the communal bathroom the provider had not taken action to minimise the risk of infection or improve the layout and equipment used within the bathroom to ensure the safety of people and meet their needs.

The home was clean and comfortably furnished. People had their own bedroom, which were personalised with their own belongings. Staff had received health and safety training that included infection control.

People who use the service used a range of communication methods. These included non-verbal to limited verbal communication supplemented by use of pictures and objects of reference to indicate their needs and wishes.

There were robust processes in place to monitor the safety of giving people their medicine.

The recruitment and selection process helped to ensure people were supported by staff of good character. There was a sufficient number of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

People were provided with effective care from a staff team who had received support through supervision and training. Their care plans detailed how they wanted their needs to be met and these were regularly reviewed to ensure they were person centred. Risk assessments identified risks associated with personal and health related issues. They helped to promote people’s independence whilst minimising the risks.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people and their care.

The registered manager had made a positive impact. People received good quality care. Staff treated people with kindness and respect. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had not ensured the communal bathroom and equipment within was safe to use for the intended purpose. You can see what action we told the provider to take at the back of the full version of this report.

We did not speak to people who use the service as part of this inspection .

During our inspection we observed the atmosphere was relaxed and welcoming. Relatives of people who use the service were complimentary about the care their relatives received. One relative told us, 'They (staff) are all very friendly and welcoming when I come into the home.' A person who uses the service said, 'Everything they (staff) do well.'

Care was planned with the involvement of the people who use the service and their relatives. Support plans reflected their individual needs. We found people were provided with appropriate care to meet their needs.

During our inspection we observed a clean environment throughout the home. Relatives we spoke with told us the home was always kept clean and tidy. People were protected from the risk of infection because the guidelines published by the Department of Health had been followed.

All the required information checks were in place prior to the employment of staff with the exception of full employment histories. The provider was unable to provide a satisfactory explanation for gaps in employment histories. This meant the provider did not have an effective recruitment process, to ensure that people who use the service were not placed at risk of being cared for by staff who were not suitable.

There were processes in place for recording, investigating and resolving complaints from people who use the service and their relatives. The provider had written information on their complaints procedure, including a version in a format appropriate for people's needs. These had been made available to people who use the service and their relatives.

People's records were accurate and fit for purpose. People's records could be located promptly when requested.

Relatives told us staff treated the people with respect and supported them to make their own choices. One relative commented that staff 'treat all people living at the home as individuals and with respect. They always knock on their doors before they enter their bedrooms.'

We observed staff communicating and listening to people in a respectful and meaningful way. We spoke with staff and looked at people's support plans and daily records and found that their needs were assessed. People's care and support was planned and delivered in line with their individual support plans. People living at the home were protected from the risk of abuse. People we spoke with told us they felt safe. Relatives felt that they would be comfortable to raise concerns with the manager.

Staff were supported to deliver care safely and to an appropriate standard. They had attended appropriate training and supervision. The provider had a system for monitoring the quality of service provided. There were processes in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.